Since its first description in 2012 [
[1]
], underwater endoscopic mucosal resection (U-EMR) has become an increasingly recognised
technique for resection of mucosal lesions of the gastrointestinal (GI) tract as an
alternative to submucosal injection-dependent endoscopic mucosal resection (EMR).
In selected cases, U-EMR has been shown to obviate the need for submucosal lifting.
This was originally described by Binmoeller et al. [
[1]
] who through their observations at endoscopic ultrasound (EUS), found that mucosal
lesions tend to ‘float away’ from the deeper wall-layers of the GI tract, once immersed
in liquid. This allows for safe and rapid resection of mucosal lesions, with the technique
being particularly useful in challenging anatomic locations such as the duodenum,
where the submucosal injectate tends to disperse itself very rapidly [
2
,
3
]. Within the upper GI tract and small bowel however, U-EMR requires the infusion of
several litres of water, raising the risk of the already documented adverse event
of water intoxication and its associated potentially serious sequelae [
[2]
].To read this article in full you will need to make a payment
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References
- Underwater EMR without submucosal injection for large sessile colorectal polyps (with video).Gastrointest Endosc. 2012; 75: 1086-1091
- Underwater EMR of sporadic laterally spreading nonampullary duodenal adenomas (with video).Gastrointest Endosc. 2013; 78: 496-502
- Duodenal endoscopic submucosal dissection is feasible using the pocket-creation method.Endoscopy. 2017; 49: 8-14
- Underwater endoscopic submucosal dissection for superficial esophageal neoplasms.Gastrointest Endosc. 2017; 85: 251-252
- Underwater endoscopic submucosal dissection: a novel technique for complete resection of a rectal neuroendocrine tumor.Endoscopy. 2016; 48 (UCTN:E67-8.)
Article info
Publication history
Published online: September 01, 2017
Accepted:
August 18,
2017
Received in revised form:
July 23,
2017
Received:
March 13,
2017
Identification
Copyright
© 2017 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
